RealMental

Princess is back in the hospital. School started on August 25, and I have been monitoring her homework (checking her agenda book and comparing it to the completed work in her binder) and asking her about her school day and doing my best to keep the line of communication open. She met with her therapist on the Saturday before school started and again this past Saturday so she could first prepare herself to return to school and then process the first (partial) week of school to assess its success. Everything seemed fine.

When I picked Princess up from her aftercare program on Tuesday, I had a message that the school counselor wanted to see me. Princess and I gathered her things and sat down in the counselor’s office to talk. The counselor relayed that another student came to her to say that Princess had indicated that she was planning to bring a knife to school for the purpose of stabbing herself or cutting her throat. She’s never articulated a plan before, and never expressed thoughts so boldly violent. The counselor advised me that she would need written confirmation from some mental health professional regarding Princess’ abililty to return to class.

We made an appointment with the therapist, and Princess was vehement in saying she did not want to go back to the hospital. She later had an outburst that culminated in her locking herself in the bathroom, refusing to speak to me, and I told her through the door that if I could not get the key to work, I would call 911 and have them break the door down and take her to the ER in an ambulance. She came out, and finally admitted that her thoughts were too overwhelming to handle alone, and she thought she needed to go back to the hospital.

We arrived at the pediatric ER around 2:00. We met with the intake nurses and pediatrician and social worker. We waited for word about which hospital had a bed and would accept her into the program. I called and texted my husband (who was home with the boys) and my parents and my siblings with updates through the night. The food service people delivered Princess’ dinner to the adult ER, so it was cold by the time we hunted it down, but she ate it anyway. They fixed another dinner for her, so I ended up getting to eat something, too. The ambulance transport came just before midnight. I took my car and agreed to meet them at the hospital.

About halfway to the hospital, my car blew a tire. I sat at the side of the highway, sobbing so hard I thought I would vomit. My  husband called the pediatric ER staff, who called the transport company, who contacted the ambulance driver to  have him come back to get me. Another bus from the same transport company arrived a few minutes after we did, so the drivers kept me distracted with their chatter. I barely remember filling out the paperwork for the intake. The coordinator on the unit asked me if I had a ride home, and I asked her to help me call a cab. She did one better- she arranged for a transport voucher for me, since I wasn’t sure I had enough cash on me to pay for the 40 minute ride home.

I got about 3 hours of sleep before taking the boys to school and coming into the office. My boss is wonderfully understanding and supportive, and is allowing me to make my schedule day by day depending on what I feel I need. I don’t know what it is I need, though.

I am still standing, and I know that Princess is getting the help she needs. This is a different hospital than the one she was in during May. That program seemed to work then, but the doctor’s willingness to dismiss my suspicions of a biploar disorder bothered me. This hospital seems more open to the possibility that there is more going on than her anxiety/depression. And we will once again find our light at the end of the tunnel

It’s back to school time, which always brings a certain amount of angst to my household. This year, though, we have an extra something hanging over our heads.

As last school year rounded toward its close, Princess had a significant downward spiral.  She began to have thoughts of self-harm and a rising number of anxiety attacks. I got a call from the school nurse on a Thursday afternoon in late May telling me that Princess had tried to choke herself.  Twenty-four hours later, she and I were both sitting in a hospital room as we waited for a placement in a pediatric psychiatric facility.  She checked in on Saturday and checked out the following Friday, but did not return to school until mid-week, and only for the non-pressure events of the end of year carnival and final school day Mass.

We enrolled Princess in an intensive outpatient program over the summer, to deal with her anxiety and further develop both her coping skills and her socialization with her peers.  Upon the advice of the medical staff at the hospital, we took her off of her ADHD medication (stimulants often exacerbate anxiety disorders) and increased the dosage of her anxiety medication. While the journey is far from over, she did learn to identify the anxiety-provoking situations and ways to keep them in proper perspective and cope with them in the best way she can.  Much of what she has learned hasn’t been put to the test yet, but she has been more cooperative at home and less likely to freak out on her brothers (which is no small feat, given Hoss’ potential for anger outbursts as a result of his mood disorder).

I remain nervous.  While the elimination of the stimulants for the ADHD is likely a good idea (the hospital staff noted Princess’ ability to focus on her work without the meds, leading to a conclusion that her previous issues may have been driven by anxiety instead of inattention), it has been close to impossible to address the anxiety created by being in middle school and dealing with the school day.  Middle school kind of sucks, even for a “normal” twelve year old.  Kids can be cruel, either by intent or by ignorance.  Add an anxiety disorder and some established socialization issues to that mix, and it’s going to be a hard road for my baby to face.  And I am once again helpless to make it OK.

My daughter is on a mild anti-depressant/anti-anxiety medication. For about two years (slightly less, actually) she’s taken it and it has helped.  She still goes to talk therapy on a regular basis, she still gets worked up over things, but I had the impression that her “worked up” is no longer getting in the way of her getting through the day.  I was wrong.

Every month when we have her medication management appointment with the psychiatrist, the doctor asks if Princess ever has thoughts of hurting herself or other people.  She always says she does not.  She told us that last Thursday, so we refilled the Rx with the same medication at the same dosage, because I thought it was working.  I was wrong.

Today I got a call from the school counselor that Princess was saying that she sometimes thinks about hurting or even killing herself. That she’s been getting messages through her account on one of the online game sites (the independent one with the upper age limit of sixteen, not one of the ones she accesses through Disney or Nickelodeon) with foul language and threats that this person is going to find who she is and where she lives. That after being upset by this person’s messages one time a couple weeks ago, she saw a knife in the kitchen and just wondered what it would be like if she just picked it up and stabbed herself so it would all be over.

I thought I was doing the right things to monitor her online activity. She does not use the chat room on this particular site, and when she is looking for games to play, alone or with her little brothers, I urge her toward the the ones allied with the children’s channels or ones that I know have a fairly strict filtering mechanism for user messages. I thought I had developed an open line of communication with my children about what’s going on in their heads. I was wrong.

The school had a speaker last week to teach the middle school students about cyber safety and cyber bullying. She and I talked about the presentation, and all of the things online that are OK and not OK to say or do, the things that are OK and not OK for someone to do or say to us. I didn’t think we had a problem. I was wrong.

I’ve got a message into the psychiatrist who handles her meds and am trying to get an appointment this week with the LCSW she sees each month for her other counseling.  We are going to review her messages tonight (the ones she has not deleted) so we can report the user sending her the offending messages.  I am going to protect my daughter and she is going to be OK. 

I really hope I’m  not wrong.

Today is Tuesday, March 16.  The day started fairly mildly- no one wanted to wake up, but we managed to get awake and fed and medicated at something approximating “on time.”  One year ago today, I think the day started just as mildly, but it didn’t stay that way.

By 10:30 a.m. on March 16, 2009, Hoss had run far enough away from the school building to have needed the police to be called.  His escaping behaviors and his total lack of understanding as to the reasons why I worried had become more than I could handle.  By noon, I had picked him up from the school and was on my way to take him to the emergency room to request a psychiatric consultation and recommendation for admittance for an inpatient evaluation.  The school counselor followed me to the hospital (regulations prohibited her from driving us herself) and, with the full support of the administration, she stayed with me for four and a half hours as we met with doctors and nurses and explained Hoss’ outbursts and his behaviors in which he put himself in harm’s way.  After the counselor left, I spent a few hours with Hoss in the psychiatric wing of the hospital as we waited for paperwork and transport to the child and adolescent unit at Sheppard Pratt.  My husband came by and stayed with us until after dinner and followed us to the pscyh hospital.  My mom spent the night in Hoss’ bed, since it was nearly midnight when we returned home, and I didn’t want a tired, worried grandmother on the road.

I am sure Hoss has no memory of the date, and only hazy memories of what happened that day.  But it is going to eat at me all day long.  He’s come so far in the past year, but we’ve had some bumps of late and I fear for what they mean.  His regular monthly appointment with his doctor is tomorrow, and it may be time to adjust medications to account for his growing system.  I have learned so much about pediatric mood disorders in the past year, and yet I have so very much that I still don’t understand and that I can’t handle.  I have a lot of years ahead of us that I need to deal with.

I’ve had a lot to say, and yet nothing to put to words.  And time has just slipped away from me, as I let myself get pulled into the swirl of holiday planning and meetings and snow days and doctor appointments and life in general.

During the snowstorm earlier this month, I was knitting a pair of gloves.  I had leftover sock yarn, a funky self-striping pattern, and I found a pattern in one of my magazines for fingerless gloves with mitten hands to fold over them (that probably makes no sense whatsoever, but I suppose what I was knitting isn’t the point of the story).  I started a new skein of yarn for making the mitts with the intention of picking up the pattern somewhere near the same point in which the hand pattern fell.  That way the stripes would match up, there would be no jarring change in the color sequences.  I pulled the yarn from the center of the skein, and instead of unspooling neatly, it came out in a huge tangled clump.  I worked at the clump to untangle it, winding the yarn into a neat ball as I went.  I was bound and determined to have my tools perfectly ready so I could make this glove coordinate, make the patterns align.   I worked at that gigantic tangled mess of yarn for close to two hours- I didn’t realize how much time I was spending as I was going, I was just focused on the task at hand.

Then the yarn broke.

That tangled mess of yarn became a metaphor.  In the end, I started the mitt part of the project at a slightly different point than I’d intended to, since I wasn’t able to properly judge the coloring to make it perfect.  I know that there is a glitch in my mitten.  I had an extra yarn tail to weave in at the end because of the split, so there are technically two glitches from having to add an extra joint. No one else can tell.  No one else would think to look.  I spent a ton of time trying to work through a problem that wasn’t really all that much of a problem, and instead ended up damaging my yarn.  The final mittens are warm, and they are a quirky pattern that makes people smile when they see me wear them.  I made a mistake and I recovered from it and it didn’t detract from the final outcome.

I’m not always like that with my knitting, I often turn my goofed up stitches into ‘design elements,’ but I am like that too much with my life.  I spent so much of the past year worrying that the decision to put Hoss in the hospital or the delay in getting him into another therapy group or my losing my temper with him when he can’t focus is negatively affecting his daily life.  I see his outbursts, which are less frequent and less intense than a year ago, and I wonder why I haven’t been able to give him the tools to stop them.  I get so entranced by untangling the knots that I forget to go ahead and start the damned stitching so the mittens can be ready to wear.

We are rapidly approaching the first anniversary of that hospital stay.  I’m alternately thankful for the progress he’s made and the help we’ve gotten from the school and the doctors and my family and everyone, and being scared of becoming complacent.   I don’t have a pattern to tell me how this is supposed to turn out.

Happy Thanksgiving (to my fellow Americans.  To my Canadian friends, please accept my more-than-a-month tardiness with the sentiment.)  And I really am thankful. 

I am thankful for my children playing on the Wii downstairs.  Little Joe ventured into the TV room downstairs today on his own.  He did not have any conditions for which doors could be open, or which lights could be lit.  He did not tell me that there were monsters in the room, or that the electronics had been turned on in the wrong order.  He just walked in.  Hoss is taking his turn, and giving his brother and sister theirs, and congratulating others for scoring.  No remotes (or fits) have been thrown.  Princess is feeling pride in the games in which she succeeds, and trying to improve in the games in which she does not, without quitting or convicing herself that the efforts are useless or that she is a lesser person because her little brothers won.

I am thankful for the homecoming festivities that will keep Hubby occupied late into the evening, and the empty bed that he will fill at his mother’s house, and the early morning golf round.  He has many friends to visit with tonight, and a short drive to a safe place to sleep.  He has the capability to walk an eighteen hole course.  He is not lying in a hospital recovering from a stroke.

I am thankful for the laptop on which I type, although it is not my property.  The organization that employs me keeps me more busy than I sometimes care to be.  Being busy, however, means that I am needed and the amount of work I am giving by the upper level people shows me that I am trusted.  “Employed and valued” is a precious place to be.

I am thankful for Vanna  White and Deborah Norville, and for the reasonably priced craft stores who carry their yarns.  There is a half-finished sock on my needles right now, destined for to be completed and matched with a mate in time to be a Christmas gift for my brother’s girlfriend.  And I am thankful for the members of my family who act like they appreciate receiving whatever projects struck me and kept my hands busy so they would not be putting unnecesary food in my mouth each evening.  Whether everyone actually likes what I give them or whether they are humoring me doesn’t even matter at this point- if they hate the stuff I make, they put up a good front.

I am thankful for this site.  I am thankful for a save haven, where no one recoils from me at the mention of having my eight year old on a twice daily dose of stimulants and anti-psychotics.  A place where, if I say that it’s a dark day, no one tells me that I just need to snap out of it or go jogging or some such thing.  I am thankful that I can read from adults who encountered their mood disorders as children, and yet made it to adulthood moderately unscathed and without a scarlet “I” for “insane” across their chests- that gives me some hope for my children to blend in and make it through their rocky childhoods.

I’m thankful we’ve all made it through another year.  2009 has been a hell of a year, and I still have one more month of it to face, but we have made it.   I’ve weathered more than I was aware I could weather.  I’ve attended more weddings this year than funerals, bought more baby shower cards than ‘get well soon’ ones.  And I have found, even in the years that seem to kick me until I feel like I can’t take another breath, that there is always something for which I can be thankful.

The child I talk about in the third paragraph of the following post would have had her birthday a few days ago.  I recently lamented that I hadn’t done the right thing by Hoss in a timely manner, that maybe if I’d undergone testing and treatment and medication and such years before, maybe we wouldn’t have face an expulsion and a stay in the mental hospital.  Now I realize that I need to just be grateful that I was finally able to figure out something to do so I wouldn’t lose him for real.  Maybe he sometimes hates me, and maybe some other people don’t understand why I do the things I do to parent him (or my other offbeat offspring), but at least I  have the chance to try my best.

Lost (originally published April 8, 2009 on Mamakaren.com)

I lost Hoss in a parking lot once.  I put him in the van and came around to the other side door to connect Little Joe’s baby seat, and Hoss took that brief moment to climb out and run away.  For a moment, I froze.  I couldn’t run around to look for him without leaving my other children unprotected, but I couldn’t stay where I was.  Thankfully, I was coherant enough to be able to describe his build and looks and clothing to the passers-by who heard me screaming his name, and one of those kind hearted folks led him back to me before he had a chance to get hit by a car or wander back into Target or anything more worrisome.  I learned my lesson, and watched him more closely when we were out, and I vowed that I couldn’t think of how badly things couldn’t have been.

Hoss’ issues seem very similar to those exhibited by one of my cousins.  Jamie is an adult now, but during his teenage years, he hit depths that I wouldn’t wish on my worst enemy.  I suspect that the research that exist today, the studies that have come to light about bipolor disorder and ADHD and all those other “disorders” with the capital D’s, the information that wasn’t available a few decades ago about how a kids’ mind might be working when he’s not a typical kid, might have prevented some of the misunderstandings and hard times and issues that he faced.  The rift between him and his parents has long since mended, and we all know that the pain he caused himself and those he loves were not coming from any place of malice or bad intention (in fact, you’d be hard pressed to find a more deeply caring person than he is).  My Nanna told me years ago that she felt, in some ways, so much more strongly for Jamie than for some of the rest of us.  She described him as being a lost soul, and prayed that he’d find his way back, and I’m guessing that she now says some prayers of gratitude that he wasn’t lost forever.

I’ve seen today a huge series of tweets and blog posts and online bonding over a loss experienced by a woman I have never met, and do not even know in a cyber-sense, much less a real-life one.  I’d link to the information, but the traffic to her blog is so heavy right now that no links work.  In any case, I saw the Twitter posts, and figured out very quickly that this beautiful, precious 17-month old had succumbed to what I assume is RSV.  It seems to me as though it happened quickly, probably in a mind-blowingly surreal whirwind.

I’ve never read this mother’s blog, never followed her tweets, but seeing this gripped my heart in a way I can’t fully articulate.  The fog I lived in for those weeks last month, the fatigue and numbness I felt when I came back from visiting hours, and the bursts of tears I had when I let the numbness wear off, all of that is nothing.  Hoss is here.  He’s here and he’s breathing and he’s laughing.  And this woman’s baby girl is not.   For the rest of her life, she’s got an invisible wound that never quite goes away.  And she’s got support and prayers and life will go on for her, for her husband, for the rest of her family.  But she’s never going to regain what she lost.